Applicant / Event Information
Date of Application
*
-
Month
-
Day
Year
Date
Event Coordinator
*
Event Name
*
Address of Applicant or Organization
*
Street Address
City
Province
Postal Code
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Alternate Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Signature
*
Event Details
Level 2 First Aid minimum mandatory for all facility bookings (100+ people).
Number of Attendees
*
Start Date
*
-
Month
-
Day
Year
Date
Start Time
*
End Date
*
-
Month
-
Day
Year
Date
End Time
*
Second Choice Start Date
-
Month
-
Day
Year
Date
Second Choice End Date
-
Month
-
Day
Year
Date
Third Choice Start Date
-
Month
-
Day
Year
Date
Third Choice End Date
-
Month
-
Day
Year
Date
Safety Contact
First Aid Contact Name
First Aid Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
First Aid Contact Email
example@example.com
Facility and IT / Tech Support
Facility Requested
*
Main Gymnasium
Takaya Room (West)
Eslha7an Room (East)
Bus Transportation
Kitchen Access
Xwmélch’sten (Capilano Field)
Lacrosse Box
Other
IT / Tech Support
Projector / Screen
PA System – Wireless Mics
On-site Tech Support & Set up
Podium
Options
Table Plastic Cloths
Dividers / Picture Display Aisles (5)
Wifi SNwireless (ask reception for password)
Coffee / Tea Service
Cross (Funerals)
Candles (Funerals)
Mandatory Date and time of test trial
Test Trial Date & Time
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Contact Name
Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Transportation Contact
Name of Bus Driver
Bus Driver Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
North Vancouver Pick Up Schedule
Seymour IR Mailboxes
Eslha7an LC
Mission Road & 1st Street
Jacobs & Jacobs
Mathias Road
Ikwikws Road
Reminder: Pick up schedule should be
one hour prior
to the start time of the event.
Setup and Rental Details
Set up date
-
Month
-
Day
Year
Date
Set up time
Name of Rental Company
Rental Company Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Rental Drop off at Facility - Date
-
Month
-
Day
Year
Date
Rental Drop off at Facility - Time
Rental Pick up at Facility - Date
-
Month
-
Day
Year
Date
Rental Pick up at Facility - Time
Additional Notes (Event/Rentals)
Catering Details
Name of Caterer or Business
Catering Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Kitchen Access
-
Month
-
Day
Year
Date
Time of Kitchen Access
Hour Minutes
AM
PM
AM/PM Option
Catering Certificates Provided
Food Safe
Red Seal
Additional Notes/Reminders (Catering)
Office Use - Approval
To be completed by authorized staff only. Please do not fill out this section.
Accepted by
Date of Accepted
-
Month
-
Day
Year
Date
Approved by
Approval Date
-
Month
-
Day
Year
Date
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